The emergence of Leishmania major and Leishmania donovani in southern Turkey

Transactions of the Royal Society of Tropical Medicine and Hygiene (Impact Factor: 1.84). 01/2014; 108(3). DOI: 10.1093/trstmh/trt119
Source: PubMed


In southern Turkey, Leishmania tropica and L. infantum are both the causative agents of cutaneous leishmaniasis (CL) and visceral leishmaniasis (VL), respectively. However, L. major and L. donovani were known to exist after the influx of Syrian refugees.
Between the years of July 2003 and July 2013, a total of 167 smears and 113 bone marrow samples were taken from CL and VL-suspected cases, respectively. Samples were analysed through real-time PCR and ITS1 DNA sequencing.
One hundred and seven 64% (107/167) smears and 56% (63/113) bone marrow samples were positive for leishmaniasis according to the real-time PCR. Three different Leishmania species were found in the 107 CL cases by real-time PCR: 42% (45/107) L. tropica, 36.5% (39/107) L. infantum and 21.5% (23/107) L. major. In addition, three different Leishmania species were identified in the 63 VL cases: 60.3% (38/63) L. infantum, 30.2% (19/63) L. donovani and 9.5% (6/63) L. tropica using real-time PCR. The results of real-time PCR were confirmed with Leishmania ITS1 DNA sequencing.
This study revealed that in southern Turkey, L. major and L. donovani were the aetiological agents of CL and VL, respectively. It was assumed that emergence of L. major and L. donovani was due to influx of Syrian refugees, as well as the effects of global warming.

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    • "These three isolates were later analyzed using MLEE and detected as Leishmania donovani zymodeme MON- 309 (Gouzelou et al., 2012). Recently, Leishmania major and L. donovani as causative agents of CL were reported in Adana Province, one of the major cities in C ¸ ukurova Plain (Koltas et al., 2014). Although VL cases in children and adults are only sporadically reported in the area (Kursun et al., 2013), hundreds of human CL cases continue to occur every year, most of them suffering from relatively small, non-ulcerating lesions (local health authorities record). "
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    ABSTRACT: The diagnosis of canine leishmaniasis (CanL) in symptomatic and asymptomatic dogs is a very important and problematic public health issue in Turkey. A longitudinal study was carried out on dogs in selected villages in the C ¸ ukurova Plain in Turkey, from July 2011 to June 2013, where cutaneous (CL) and visceral (VL) leishmaniasis is endemic. The study aimed to determine the prevalence of CanL and to evaluate the early diagnostic performance of the non-invasive conjunctival swab nested PCR (CS n-PCR) test in comparison with the Indirect Fluorescent Antibody Test (IFAT). The consecutive blood and CS samples from a representative number of dogs (80–100 dogs/each survey) were collected in a cohort of 6 villages located in the area. Clinical symptoms, demographic and physical features about each dog were noted and lymph node aspiration samples were obtained from selected dogs with lymphadenopathy. In four surveys during the period, a total of 338 sets (blood and CS) of samples from 206 dogs were obtained, such that 83 dogs were sampled more than once. In the cross-sectional analysis, the CanL prevalence was found to be 27.18% (between 7.14% and 39.13%) by IFAT and 41.74% (between 29.03% and 46.66%) by CS n-PCR. The isolated strains were identified as Leishmania infantum MON-1 (n = 9) and MON-98 (n = 2) by MLEE analysis. Genetic studies targeting the Hsp70 and ITS1 regions performed on 11 dog isolates also showed two clear separate groups. According to IFAT results, 24 of the 83 dogs sampled more than once showed seroconversion (n = 19) or a four-fold increase in Ab titers (n = 5), while 17 were positive in the initial screening. Forty-two dogs stayed negative during the whole period. The natural Leishmania exposure rate was detected as 31.14% in the study area. CS n-PCR only detected Leishmania infection earlier than IFAT in 8 dogs. No statistical difference was found after the analysis of demographical and physical data. The results indicated that (i) circulation of the dog population is very common in settlements in the C ¸ ukurova Plain, but the disease prevalence is high and stable, (ii) the performance of CS n-PCR for detecting Leishmania-dog contact is higher than IFAT, (iii) and some of the parasites isolated from dogs have different zymodemes and/or genotypes from previous human and sand fly isolates; suggesting the probability of two different cycles of leishmaniasis in this particular area. This hypothesis should be supported by future studies targeting vectors and reservoirs.
    Veterinary Parasitology 09/2015; DOI:10.1016/j.vetpar.2015.09.009 · 2.46 Impact Factor
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    • "In addition to this, two strains isolated from two VL patients were identified as " Leishmania major variant " four differing from Friedlin strain of Leishmania major in the sequences of N-acetylglucosamine-1-phosphotransferase (NAGT) genes with four bases substitutions (Akman et al., 2000). Recently L. major and L. donovani were also reported as causative agents of CL in East Mediterranean Region of Turkey (Koltas et al., 2014). South and Southeast Anatolia regions are endemic for CL, while human VL and CanL have been mainly seen along the Aegean, Mediterranean coasts and Central Anatolia Region (Ok et al., 2002). "
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    ABSTRACT: Visceral leishmaniasis (VL) has now been recorded from 38 provinces of Turkey. Twenty-one VL cases were reported within six years from settlements located in most northeastern Turkey and we therefore aimed to carry out an entomological and seroepidemiological survey in this new focus for clarifying risk factors. Blood samples from 290 children and 165 dogs were collected. Sera samples were investigated for anti-Leishmania antibodies using indirect fluorescent antibody test. Sand fly collection for determining the fauna and seasonal activity was performed in all settlements by CDC light traps between June and September 2006. Although no seropositive child was detected during the survey the overall seroprevalence rate of canine leishmaniasis was found as 7.2%. A total of 4154 sand flies were collected and 10 species of genus Phlebotomus were identified belonging to Adlerius, Larroussius, Paraphlebotomus and Phlebotomus subgenera. Among them Phlebotomus kandelakii s.l. (55.44%), Phlebotomus balcanicus (12.62%) and Phlebotomus neglectus (4.40%) was detected as probable vector species for this new focus. The poor sanitation, very high population size of sand flies, probably because of very short season, no control measures for sand flies as well as dogs, and presence of microclimate suitable for sand flies were considered as main risk factors in the area. Copyright © 2015 Elsevier B.V. All rights reserved.
    Veterinary Parasitology 02/2015; 209(3-4). DOI:10.1016/j.vetpar.2015.02.021 · 2.46 Impact Factor
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    • "Over 50% of the 2-million worldwide-appraised DALYs is mainly focused in South-East Asia, with Bihar (India) as the epicenter of Leishmania-related deaths (Alvar et al., 2012). VL is a re-emerging opportunistic disease in immunosuppressed patients owing to three main facts: (i) the immunosuppressive effect of drugs used in organ transplantation; (ii) as a consequence of HIV infections in South-European countries or (iii) climate change due to global warming (Alvar et al., 2008; van Griensven et al., 2014; Koltas et al., 2014). Although prevention is considered the best approach to fight against these diseases, any possible vaccine is in a very early stage of development. "
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    ABSTRACT: The Trypanosomatidae family, composed of unicellular parasites, causes severe vector-borne diseases that afflict human populations worldwide. Chagas disease, sleeping sickness, as well as different sorts of leishmaniases are amongst the most important infectious diseases produced by Trypanosoma cruzi, Trypanosoma brucei and Leishmania spp., respectively. All these infections are closely related to weak health care services in low-income populations of less developed and least economically developed countries. Search for new therapeutic targets in order to hit these pathogens is of paramount priority, as no effective vaccine is currently in use against any of these parasites. Furthermore, present-day chemotherapy comprises old-fashioned drugs full of important side effects. Besides, they are prone to produce tolerance and resistance as a consequence of their continuous use for decades. DNA topoisomerases (Top) are ubiquitous enzymes responsible for solving the torsional tensions caused during replication and transcription processes, as well as in maintaining genomic stability during DNA recombination. As the inhibition of these enzymes produces cell arrest and triggers cell death, Top inhibitors are among the most effective and most widely used drugs in both cancer and antibacterial therapies. Top relaxation and decatenation activities, which are based on a common nicking–closing cycle involving one or both DNA strands, have been pointed as a promising drug target. Specific inhibitors that bind to the interface of DNA-Top complexes can stabilize Top-mediated transient DNA breaks. In addition, important structural differences have been found between Tops from the Trypanosomatidae family members and Tops from the host. Such dissimilarities make these proteins very interesting for drug design and molecular intervention. The present review is a critical update of the last findings regarding trypanosomatid’s Tops, their new structural features, their involvement both in the physiology and virulence of these parasites, as well as their use as promising targets for drug discovery.
    International Journal for Parasitology: Drugs and Drug Resistance 08/2014; 4(3). DOI:10.1016/j.ijpddr.2014.07.006 · 3.29 Impact Factor
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